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Salvo 30

Salvo 30

Feature — Topic: PrudenceSalvo #30

"The Talk" 2.0

Five Sex Facts Teens Should Know by Brenda Zurita


There are five very important facts about sex that teens ought to know about but may not, because their sex-education classes may ignore the topics or give them only partial information. Giving teens the whole story, including these little-known facts, might encourage them to delay sexual activity, and thereby preserve both their health and their future happiness.

1. Vulnerability of the Immature Cervix

The first fact has to do with sexually active teen girls' vulnerability to infection due to the immaturity of their cervix. Dr. Miriam Grossman, in her book, You're Teaching My Child WHAT? explains:

The cervix, the entrance to the uterus at the end of the vagina, plays a central role in female sexual health, but few people are aware of how it increases a girl's vulnerability to sexually transmitted infections.

The cervix is the site of two of the most common sexually transmitted infections, HPV and Chlamydia. HPV is necessary for cervical cancer to develop, and Chlamydia can cause chronic pelvic inflammatory disease, ectopic pregnancies, miscarriages and infertility.

Girls under the age of twenty are being hit hardest by these epidemics. One reason is their immature cervix.

It's critical to understand this. All things being equal, the cervix of an adult is more difficult to infect than the cervix of a teen. The more mature cervix is protected by twenty to thirty layers of cells. In contrast, the cervix of a teen has a central area called the transformation zone. Here the cells are only one layer thick. The transformation zone is largest at puberty, and it slowly shrinks as the cervix matures. The thin folds of fragile, single cells are transformed progressively into a thick, flat shield with many layers. The "T-zone" can be seen during a routine pelvic exam. It makes the cervix look like a bull's eye, which is fitting, because it's exactly where the bugs want to be.1

One of the healthiest choices a teenage girl can make is to delay sexual activity until her transformation zone matures, which for most women occurs in their early twenties. Of course, waiting until marriage is the healthiest choice of all. Two uninfected people in a committed, faithful marriage will never have to worry about contracting a sexually transmitted disease.

2. Oral Sex & Throat Cancer

In 2002 the Centers for Disease Control (CDC) reported on the incidence of oral sex among persons aged 15-44 years old. According to the report, 83 percent of males and 82 percent of females engaged in oral sex with members of the opposite sex, and 5.7 percent of males engaged in oral sex with other males.2 A later CDC study, which covered only young people (aged 15-24) over the years 2007-2010, revealed that 66 percent of females and 65 percent of males had ever engaged in oral sex.3

These percentages are high, yet how many of these people are aware that oral sex is linked with throat cancer? In 2007 NewScientist.com reported on a study showing a link between the human papilloma virus (HPV), oral sex, and throat cancer. Infection with the strain HPV-16 was shown to increase the likelihood of throat cancer by 58 percent, prompting one doctor to comment, "We need to add oral HPV infection to the list of risks for oral cancer."4

A 2011 National Public Radio blog reported that, while tobacco remains the leading cause of oral cancer in most countries around the world, in the U.S., HPV is the main culprit, causing 64 percent of oropharynxl cancers.5 Just two years later, a 2013 New York Times article reported, "Now, about 70 percent of all throat cancers are caused by HPV, up from roughly 15 percent three decades ago."6

Cancer isn't the only health risk associated with oral sex. Of 49 sexually transmitted diseases identified in Concerned Women for America's report, "Sexually Transmitted Diseases: The Cost of Free Love," 46 could be transmitted through oral sex.7

Are teens using condoms to protect themselves during oral sex? Dr. Grossman quoted one 15-year-old girl as saying, "Never happened, never will." Grossman also cited a study by the National Center for Health Statistics which found that only nine percent of teens surveyed reported using condoms for oral sex.8 Experts know that promoting condom use is not the answer to the problem anyway. Teaching teens the inherent risk of engaging in casual sex is the way to keep them safer.

3. The Dangers of Anal Sex

Dr. Grossman devotes an entire chapter of her book to the dangers of anal sex. She recounts the attempt of Dr. Ruth Jacobs, an infectious disease specialist in Montgomery County, Maryland, to explain to the county school board that a video they were showing teens, titled "Protect Yourself," contained incorrect information about how much protection condoms provide:

Pivotal to Dr. Jacobs's objection to "Protect Yourself" was the absence of warnings about the danger of anal intercourse. Students were being told that HIV and other infections are shared through unprotected vaginal, oral, or anal intercourse, as if each activity carries the same risk. Dr. Jacobs wanted students to hear what she told her patients—that due to anatomy and physiology, anal sex has been estimated to be at least 20 times riskier than vaginal. Also missing was the information that condoms are more likely to fail during anal sex—a danger acknowledged on condom wrappers that warn consumers: "Non-vaginal use can increase potential damage to the condom."9

A 2005 CDC report shows the alarming extent to which teens are experimenting with anal sex. Among teenage boys 15-19 years old, 11.2 percent have engaged in anal sex. When the age range is extended to include 15-24-year-olds, the number rises to 21.7 percent. The corresponding percentages for girls and young women are 10.9 percent and 20.3 percent, respectively.10

A 2012 CDC factsheet showed that young men who have sex with men (YMSM) are at the highest risk of acquiring HIV. The report stated: "Among adolescent males aged 13-19 years, approximately 91% of all diagnosed HIV infections are from male-to-male sexual contact. From 2006 to 2009, YMSM aged 13-24 years had the greatest percentage increase in diagnosed HIV infections of all age groups."11

Dr. John R. Diggs, Jr., wrote a physiological explanation of why anal sex is dangerous. Perhaps this is the description that should be taught in sex education classes:

The rectum is significantly different from the vagina with regard to suitability for penetration by a penis. The vagina has natural lubricants and is supported by a network of muscles. It is composed of a mucus membrane with a multi-layer stratified squamous epithelium that allows it to endure friction without damage and to resist the immunological actions caused by semen and sperm. In comparison, the anus is a delicate mechanism of small muscles that comprise an "exit-only" passage.

With repeated trauma, friction, and stretching, the sphincter loses its tone and its ability to maintain a tight seal. Consequently, anal intercourse leads to leakage of fecal material that can easily become chronic. The potential for injury is exacerbated by the fact that the intestine has only a single layer of cells separating it from highly vascular tissue, that is, blood. Therefore, any organisms that are introduced into the rectum have a much easier time establishing a foothold for infection than they would in a vagina. The single layer tissue cannot withstand the friction associated with penile penetration, resulting in traumas that expose both participants to blood, organisms in feces, and a mixing of bodily fluids.12

A May 2014 study showed that unprotected receptive anal intercourse had a per-act HIV transmission risk rate of 138 per 10,000 exposures, making it 12.5 times riskier for acquiring HIV than unprotected receptive vaginal intercourse.13 Concerned Women for America's "Sexually Transmitted Diseases" report showed that anal sex is a transmission route for 33 of the 49 sexually transmitted diseases identified.14

4. The Deficiency of Condoms

Condoms are not 100-percent effective for several reasons: user error, breakage or slippage, and inconsistent usage. Even if a condom is used properly during every single sexual act and does not break or slip, the failure rates are still high. The CDC reports that the typical use failure rate for condoms is 18 percent.15 One medical source reports that, when consistently used, condoms reduce the risk of contracting HPV, genital herpes, Chlamydia, and Gonorrhea by only one-half. They are more effective against HIV/AIDS, reducing risk by 85 percent, but even that is not an especially reassuring figure.16

Moreover, those numbers only apply when condoms are used consistently and correctly. Consistent use means that a condom must be worn every single time a person engages in sex. How are teens doing with that? According to a 2011 CDC survey covering the years 2006-2010, only 66.5 percent of boys aged 15-19 used condoms 100 percent of the time.17 As for correct usage, the CDC has issued a detailed list of what that entails.18 It is hard to imagine teenagers going through all the steps successfully every time.

In short, even with consistent and correct usage, condoms only reduce the risk of acquiring a sexually transmitted disease or becoming pregnant; they do not eliminate it. And, as the figures show, consistent use is not happening.

5. Most Teens Are Abstinent

According to the 2011 CDC report, "Teenagers in the United States," the number of teens who are sexually active has been steadily declining since 1988. In that year, 51.1 percent of girls aged 15-19 reported ever having had sexual intercourse; the number dropped to 42.6 percent in the 2006-2010 survey. For boys in the same age range, the percentage dropped from 60.4 in 1988 to 41.8 in 2006-2010.19

Another CDC report covering the years 1991-2013 also showed a significant decline in teen sexual activity. According to that survey, the number of teens who had ever had sex decreased from 54.1 percent to 46.8 percent over those years, and the survey also found that only 34 percent of teenagers were currently sexually active, meaning that they had had sexual intercourse with at least one person in the three months before the survey.20

Both of these studies show that the majority of teens are not sexually active. And yet, according to the National Campaign to Prevent Teen and Unplanned Pregnancy (NCPTUP), 84 percent of teens think that most of their peers have had sex.21

Not only are most teens not having sex, the majority of those that are regret not having waited. Another NCPTUP survey asked children aged 12-19, "If you have had sexual intercourse, do you wish you had waited longer?" Among 12-14-year-olds, 78 percent wished they had, and among 15-19-year-olds, 55 percent said they wished they had waited. Among all the children, 67 percent of the girls and 53 percent of the boys wished they had waited longer.22

These data show that teens are capable of restraint. Yet many comprehensive sex education programs are based on the assumption that teens are going to have sex anyway, and therefore need lessons in how to reduce the risks. Teens are not advised to drink "lite" beer because they're going to drink anyway, or to smoke filtered cigarettes because they're going to smoke anyway; they are bluntly advised to refrain from drinking and smoking. But in many so-called comprehensive sex education programs, abstinence gets only a passing mention and is often treated dismissively, even though it is the healthiest message for teens—and one that many of them would welcome. In fact, an NCPTUP survey showed that 87 percent of teens aged 12-19 believe it is important that they receive a strong message to delay sexual activity until they are at least out of high school.23

Parental involvement is also very important to teens. When asked, 87 percent of them agreed with this statement: "It would be much easier for teens to postpone sexual activity and avoid teen pregnancy if they were able to have more open, honest conversations about these topics with their parents."24 Maybe parents could start by discussing these five facts with their teens. •



More on Prudence from the Salvo online archives.

Sexually Transmitted Infections by Marcia Segelstein

A Review of Love Thy Body: Answering Hard Questions About Life and Sexuality by Nancy R. Pearcey by Terrell Clemmons

An Interview with Nancy Pearcey by Terrell Clemmons

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